Tag Archives: medicare

MRA & FFS Normalization

This post is parenthetical to the series entitled, A Moment of Silence for the Sunsetting MRA Program. Although Medicare Advantage (MA) and the traditional Medicare program cover the same patients (called members in the former and beneficiaries in the latter), … Read Full Post

Tagged FFS, medicare, mra, risk adjustment |

The Annual Wellness Visit

The American Academy of Family Physicians defines the Annual Wellness Visit (AWV) as an opportunity to gain information about a patient, including medical and family history, health risks, and specific vitals. Its purpose is to review the patient’s wellness and … Read Full Post

Tagged Annual Wellness Visit, AWV, medicare |

What We’re Reading – Inappropriate Billing, Fraud Gaining Scrutiny

Despite the pandemic, the U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG) has not missed a beat. Regulators are still focusing on fraud and non-compliance. This article refers to a bulletin, issued in February … Read Full Post

Tagged billing audit, cms, hospital claims, medicare, OIG |

President’s Order to Protect and Improve Medicare

President Trump signed an Executive Order on October 3, 2020 aimed at protecting and improving the Medicare program. The Order outlines steps to improve fiscal sustainability of the Medicare program and plans to increase choices, flexibility and value. Below is … Read Full Post

Tagged cms, MA plans, medicare, medicare advantage, protect Medicare |

Did You Know…Medicare Pays for Depression Screenings?

According to the National Institutes of Mental Health, depression is one of the most common mental disorders in the U.S. It can begin at any age, often in adulthood, and can occur with other serous medical conditions. Research indicates that … Read Full Post

Tagged cms, depression screening, medicare, PHQ-9 |

Did You know….Medicare pays for High Intensity Behavioral Counseling?

High Intensity Behavioral Counseling (HIBC) is a program that promotes the reduction or avoidance of sexual risks. It is tailored to the unique issues and needs of the patient, and includes education, skills training, and, guidance on how to change … Read Full Post

Tagged cms, high intensity behavioral counseling, medicare, sexual risk, telehealth |

CMS Makes Changes to Telehealth Billing

This is a follow-up to an earlier blog about the Centers for Medicare and Medicaid Services’ (CMS) expanded provisions for coverage of telehealth (TH) visits for Medicare beneficiaries. CMS recently added additional billing codes to its approved list, and clarified … Read Full Post

Tagged cms, medicare, telehealth |

Did You Know… Medicare Pays for Counseling for Smoking Cessation

A staggering amount of research shows the detrimental effects smoking can have on a person’s health, and public service announcements abound on this topic. Some providers may not know that Medicare is also on this bandwagon and pays for PCPs … Read Full Post

Tagged cms, counseling, medicare, smoking cessation, telehealth |

Did You Know… Medicare Pays for Counseling for Obesity & CVD?

Intensive Behavioral Therapy (IBT) is a series of counseling sessions aimed at reducing the risk of cardiovascular disease (CVD), which can lead to heart attack or stroke. It is also used for helping patients make behavioral changes that facilitate weight … Read Full Post

Tagged cardiovascular disease, cms, IBT, IBT counseling, intensive behavioral therapy, medicare, obesity |

Did You Know…Medicare pays for Activities Related to Home Health?

In order for a home health agency to deliver physician-ordered home health services, the agency must prepare a Plan of Care (POC) for the patient that conveys the physician’s orders for the care. The POC must be signed by the … Read Full Post

Tagged care plan oversight, cms, CPO, medicare, plan of care, POC |